scholarly journals COVID-19 Viral Load Not Associated with Disease Severity: Findings from A Retrospective Cohort Study

2021 ◽  
Author(s):  
Abdulkarim Abdulrahman ◽  
Saad Mallah ◽  
Manaf AlQahtani
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Disease Severity ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Viral Loads ◽  
Using Data

Abstract Background: Being able to use COVID-19 RT-PCR Ct values as simple markers of disease outcome or prognosis would allow for the easy and proactive identification and triaging of high-risk cases. This study’s objective was thus to assess whether a correlation exists between COVID-19 viral loads, as indicated by RT-PCR Ct values, and disease severity, as indicated by respiratory indices Results: A multi-centre cross-sectional retrospective study was conducted, using data obtained from Bahrain’s National COVID-19 Task force’s centralised database. The study period was from May 2, 2020 to July 31, 2020. A multivariable logistic regression was used to assess for a correlation. The covariates adjusted for included sex, age, presentation, and comorbidities. In our cohort, Ct value showed no statistical significance for an association with requirement for oxygenation on admission (Odds ratio 1.046; 95%CI 0.999 to 1.096, p=0.054). Conclusion: Viral load, as indicated by Ct values, did not seem to be associated with requirement for oxygenation on admission in our cohort. We postulate however that time since onset of symptom may have acted as an unaccounted-for confounder.

scholarly journals COVID-19 viral load not associated with disease severity: findings from a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdulkarim Abdulrahman ◽  
Saad I. Mallah ◽  
Manaf Alqahtani
Keyword(s):  
Viral Load ◽  
Disease Severity ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Clinical Markers ◽  
Rt Pcr ◽  
Clinical Tool ◽  
Cross Sectional ◽  
Viral Loads ◽  
Using Data

Abstract Background Being able to use COVID-19 RT-PCR Ct values as simple clinical markers of disease outcome or prognosis would allow for the easy and proactive identification and triaging of high-risk cases. This study’s objective was thus to explore whether a correlation exists between COVID-19 viral loads, as indicated by RT-PCR Ct values, and disease severity, as indicated by respiratory indices. Results A multi-centre cross-sectional retrospective study was conducted, using data obtained from Bahrain’s National COVID-19 Task force’s centralised database. The study period ranged from May 2, 2020 to July 31, 2020. A multivariable logistic regression was used to assess for a correlation using data from a total of 1057 admitted COVID-19 cases. The covariates adjusted for included sex, age, presentation, and comorbidities. In our cohort, Ct value showed no statistical significance for an association with requirement for oxygenation on admission (Odds ratio 1.046; 95%CI 0.999 to 1.096, p = 0.054). Conclusion Viral load, as indicated by Ct values, did not seem to be associated with requirement for oxygenation on admission in our cohort. We postulate however that time since onset of symptom may have acted as an unaccounted-for confounder. As such, RT-PCR Ct values may not be a useful prognostic clinical tool in isolation.

scholarly journals Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110277
Author(s):  
Tyler Pitre ◽  
Angela (Hong Tian) Dong ◽  
Aaron Jones ◽  
Jessica Kapralik ◽  
Sonya Cui ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Icu Admission

Background: The incidence of acute kidney injury (AKI) in patients with COVID-19 and its association with mortality and disease severity is understudied in the Canadian population. Objective: To determine the incidence of AKI in a cohort of patients with COVID-19 admitted to medicine and intensive care unit (ICU) wards, its association with in-hospital mortality, and disease severity. Our aim was to stratify these outcomes by out-of-hospital AKI and in-hospital AKI. Design: Retrospective cohort study from a registry of patients with COVID-19. Setting: Three community and 3 academic hospitals. Patients: A total of 815 patients admitted to hospital with COVID-19 between March 4, 2020, and April 23, 2021. Measurements: Stage of AKI, ICU admission, mechanical ventilation, and in-hospital mortality. Methods: We classified AKI by comparing highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage of AKI and the outcomes of ICU admission, mechanical ventilation, and in-hospital mortality. Results: Of the 815 patients registered, 439 (53.9%) developed AKI, 253 (57.6%) presented with AKI, and 186 (42.4%) developed AKI in-hospital. The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death (odds ratio [OR] = 7.87 [4.35, 14.23]). Stage 3 AKI that occurred prior to hospitalization carried an increased odds of death (OR = 5.28 [2.60, 10.73]). Limitations: Observational study with small sample size limits precision of estimates. Lack of nonhospitalized patients with COVID-19 and hospitalized patients without COVID-19 as controls limits causal inferences. Conclusions: Acute kidney injury, whether it occurs prior to or after hospitalization, is associated with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney function in patients with COVID-19 may improve risk stratification. Trial registration: The study was not registered on a publicly accessible registry because it did not involve any health care intervention on human participants.

scholarly journals Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine-breakthrough infections: a multi-center cohort study

2021 ◽  
Author(s):  
Po Ying Chia ◽  
Sean Ong ◽  
Calvin J Chiew ◽  
Li Wei Ang ◽  
Jean-marc Gilbert Chavatte ◽  
...  
Keyword(s):  
Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Spike Protein ◽  
Serological Response ◽  
Oxygen Supplementation ◽  
Viral Loads ◽  
The World ◽  
Highly Effective ◽  
Kinetics Of

Objectives Highly effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed but variants of concerns (VOCs) with mutations in the spike protein are worrisome, especially B.1.617.2 (Delta) which has rapidly spread across the world. We aim to study if vaccination alters virological and serological kinetics in breakthrough infections. Methods We conducted a multi-centre retrospective cohort study of patients in Singapore who had received a licensed mRNA vaccine and been admitted to hospital with B.1.617.2 SARS-CoV-2 infection. We compared the clinical features, virological and serological kinetics (anti-nucleocapsid, anti-spike and surrogate virus neutralization titres) between fully vaccinated and unvaccinated individuals. Results Of 218 individuals with B.1.617.2 infection, 84 had received a mRNA vaccine of which 71 were fully vaccinated, 130 were unvaccinated and 4 received a non-mRNA. Despite significantly older age in the vaccine breakthrough group, the odds of severe COVID-19 requiring oxygen supplementation was significantly lower following vaccination (adjusted odds ratio 0.07 95%CI: 0.015-0.335, p=0.001). PCR cycle threshold (Ct) values were similar between both vaccinated and unvaccinated groups at diagnosis, but viral loads decreased faster in vaccinated individuals. Early, robust boosting of anti-spike protein antibodies was observed in vaccinated patients, however, these titers were significantly lower against B.1.617.2 as compared with the wildtype vaccine strain. Conclusion The mRNA vaccines are highly effective at preventing symptomatic and severe COVID-19 associated with B.1.617.2 infection. Vaccination is associated with faster decline in viral RNA load and a robust serological response. Vaccination remains a key strategy for control of COVID-19 pandemic.

scholarly journals Can initial chest CT scan predict status and clinical outcomes of COVID-19 infection? A retrospective cohort study

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Iman Abdollahi ◽  
Mehrdad Nabahati ◽  
Mostafa Javanian ◽  
Hoda Shirafkan ◽  
Rahele Mehraeen
Keyword(s):  
Cohort Study ◽  
Ct Scan ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
Chest Ct ◽  
Rt Pcr ◽  
Icu Admission ◽  
Chest Ct Scan

Abstract Background We aimed to investigate the association of initial chest CT scan findings with status and adverse outcomes of COVID-19 (including ICU admission, mortality, and disease severity). This retrospective cohort study was performed in three hospitals in Babol, northern Iran, between February and March 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). Clinical and paraclinical data of the patients were collected from their medical records. CT severity score (CSS) was calculated by a senior radiologist. Disease severity was determined based on the World Health Organization criteria. Results In total, 742 patients were included, of whom 451 (60.8%) were males and 291 (39.2%) were females. The mean age was 56.59 ± 14.88 years old. Also, 523 (70.5%) were RT-PCR-positive. Ground glass opacity was directly associated with RT-PCR positivity (odds ratio [OR] = 2.07). Also, RT-PCR-positive cases had significantly a higher CSS than RT-PCR-negative cases (p = 0.037). In patients confirmed with COVID-19, peribronchovascular distribution of lesions, number of zones involved, and CSS were associated with increased risk of ICU admission (OR = 2.93, OR = 2.10, and OR = 1.14, respectively), mortality (OR = 2.30, OR = 1.35, and OR=1.08, respectively), severe disease (OR = 2.06, OR = 1.68, and OR = 1.10, respectively), and critical disease (OR = 4.62, OR = 3.21, and OR = 1.23, respectively). Also, patients who had consolidation were at a higher risk of severe disease compared with those who did not (OR = 4.94). Conclusion Initial chest CT scan can predict COVID-19 positivity, ICU admission, mortality, and disease severity, specifically through CSS.

scholarly journals Is Higher Viral Load in SARS-CoV-2 Associated With Death?

2020 ◽  
Author(s):  
Klinger Soares Faico-Filho ◽  
Victor Cabelho Passarelli ◽  
Nancy Bellei
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Disease Severity ◽  
Prognostic Marker ◽  
Patient Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
High Viral Load ◽  
Nasopharyngeal Swab

There is no proven prognostic marker or adequate number of studies in patients hospitalized for Coronavirus Disease-2019 (COVID-19). We conducted a retrospective cohort study of patients hospitalized with COVID-19 from March 14 to June 17, 2020, at Sao Paulo Hospital. SARS-CoV-2 viral load was assessed using the cycle threshold (Ct) values obtained from an RTPCR assay applied to the nasopharyngeal swab samples. Disease severity and patient outcomes were compared. Among the 875 patients, 50.1% (439/875) had mild, 30.4% (266/875) moderate, and 19.5% (170/875) severe disease. A Ct value of <25 (472/875) indicated a high viral load, which was independently associated with mortality (OR: 0,34; 95% CI: 0,217 to 0,533; p < 0.0001). Admission SARS-CoV-2 viral load is an important surrogate biomarker of infectivity and is independently associated with mortality among patients hospitalized with COVID-19.

An Analysis of Dental Implants Survival and Success

2018 ◽  
Vol 69 (9) ◽  
pp. 2465-2466
Author(s):  
Iustin Olariu ◽  
Roxana Radu ◽  
Teodora Olariu ◽  
Andrada Christine Serafim ◽  
Ramona Amina Popovici ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Medical History ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Demographic Data ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Health Related

Osseointegration of a dental implant may encounter a variety of problems caused by various factors, as prior health-related problems, patients� habits and the technique of the implant inserting. Retrospective cohort study of 70 patients who received implants between January 2011- April 2016 in one dental unit, with Kaplan-Meier method to calculate the probability of implants�s survival at 60 months. The analysis included demographic data, age, gender, medical history, behavior risk factors, type and location of the implant. For this cohort the implants�survival for the first 6 months was 92.86% compared to the number of patients and 97.56% compared to the number of total implants performed, with a cumulative failure rate of 2.43% after 60 months. Failures were focused exclusively on posterior mandible implants, on the percentage of 6.17%, odds ratio (OR) for these failures being 16.76 (P = 0.05) compared with other localisations of implants, exclusively in men with median age of 42 years.

scholarly journals Viral Dynamics and Real-Time RT-PCR Ct Values Correlation with Disease Severity in COVID-19

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1091
Author(s):  
Ali A. Rabaan ◽  
Raghavendra Tirupathi ◽  
Anupam A Sule ◽  
Jehad Aldali ◽  
Abbas Al Mutair ◽  
...  
Keyword(s):  
Viral Load ◽  
Real Time ◽  
Disease Severity ◽  
False Negative ◽  
Influential Factors ◽  
Confirmatory Test ◽  
Acid Extraction ◽  
Rt Pcr ◽  
Viral Kinetics ◽  
Ct Value

Real-time RT-PCR is considered the gold standard confirmatory test for coronavirus disease 2019 (COVID-19). However, many scientists disagree, and it is essential to understand that several factors and variables can cause a false-negative test. In this context, cycle threshold (Ct) values are being utilized to diagnose or predict SARS-CoV-2 infection. This practice has a significant clinical utility as Ct values can be correlated with the viral load. In addition, Ct values have a strong correlation with multiple haematological and biochemical markers. However, it is essential to consider that Ct values might be affected by pre-analytic, analytic, and post-analytical variables such as collection technique, specimen type, sampling time, viral kinetics, transport and storage conditions, nucleic acid extraction, viral RNA load, primer designing, real-time PCR efficiency, and Ct value determination method. Therefore, understanding the interpretation of Ct values and other influential factors could play a crucial role in interpreting viral load and disease severity. In several clinical studies consisting of small or large sample sizes, several discrepancies exist regarding a significant positive correlation between the Ct value and disease severity in COVID-19. In this context, a revised review of the literature has been conducted to fill the knowledge gaps regarding the correlations between Ct values and severity/fatality rates of patients with COVID-19. Various databases such as PubMed, Science Direct, Medline, Scopus, and Google Scholar were searched up to April 2021 by using keywords including “RT-PCR or viral load”, “SARS-CoV-2 and RT-PCR”, “Ct value and viral load”, “Ct value or COVID-19”. Research articles were extracted and selected independently by the authors and included in the present review based on their relevance to the study. The current narrative review explores the correlation of Ct values with mortality, disease progression, severity, and infectivity. We also discuss the factors that can affect these values, such as collection technique, type of swab, sampling method, etc.

scholarly journals Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

2021 ◽  
Vol 18 (1) ◽  
pp. 323
Author(s):  
Oladele Vincent Adeniyi ◽  
David Stead ◽  
Mandisa Singata-Madliki ◽  
Joanne Batting ◽  
Leo Hyera ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infection Rate ◽  
Healthcare Workers ◽  
Health Facilities ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Eastern Cape ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Increased Risk

Healthcare workers (HCWs) are at increased risk of infection by the virulent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Though data exist on the positivity rate of the SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test as well as COVID-19-related deaths amongst HCWs in South Africa, the overall infection rate remains underestimated by these indicators. It is also unclear whether the humoral immune response after SARS-CoV-2 infection offers durable protection against reinfection. This study will assess the SARS-CoV-2 seroprevalence amongst HCWs in the Eastern Cape (EC) and examine the longitudinal changes (rate of decay) in the antibody levels after infection in this cohort. Using a multi-stage cluster sampling of healthcare workers in selected health facilities in the EC, a cross-sectional study of 2250 participants will be recruited. In order to assess the community infection rate, 750 antenatal women in the same settings will be recruited. Relevant demographic and clinical characteristics will be obtained by a self-administered questionnaire. A chemiluminescent microparticle immunoassay (CMIA) will be used for the qualitative detection of IgG antibodies against SARS-CoV-2 nucleocapsid protein. A nested cohort study will be conducted by performing eight-weekly antibody assays (X2) from 201 participants who tested positive for both SARS-CoV-2 RT-PCR and serology. Logistic regression models will be fitted to identify the independent risk factors for SARS-CoV-2 infection. The cumulative SARS-CoV-2 infection rate and infection fatality rate among the frontline HCWs will be estimated. In addition, the study will highlight the overall effectiveness of infection prevention and control measures (IPC) per exposure sites/wards at the selected health facilities. Findings will inform the South African Department of Health’s policies on how to protect HCWs better as the country prepares for the second wave of the SARS-CoV pandemic.

scholarly journals General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junette Arlette Mbengono Metogo ◽  
Theophile Njamen Nana ◽  
Brian Ajong Ngongheh ◽  
Emelinda Berinyuy Nyuydzefon ◽  
Christoph Akazong Adjahoung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Regional Anaesthesia ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
Neonatal Resuscitation ◽  
Maternal Outcomes ◽  
Foetal Distress

Abstract Background Acute foetal distress (AFD) is a life-threatening foetal condition complicating 2% of all pregnancies and accounting for 8.9% of caesarean sections (CS) especially in developing nations. Despite the severity of the problem, no evidence exists as to the safest anaesthetic technique for the mother and foetus couple undergoing CS for AFD. We aimed to compare general anaesthesia (GA) versus regional (spinal and epidural) anaesthesia in terms of their perioperative maternal and foetal outcomes. Methods We carried out a retrospective cohort study by reviewing the medical records of all women who underwent CS indicated for AFD between 2015 to 2018 at the Douala General Hospital, Cameroon. Medical records of neonates were also reviewed. We sought to investigate the association between GA, and regional anaesthesia administered during CS for AFD and foetal and maternal outcomes. The threshold of statistical significance was set at 0.05. Results We enrolled the medical records of 117 pregnant women who underwent CS indicated for AFD. Their mean age and mean gestational age were 30.5 ± 4.8 years and 40 weeks respectively. Eighty-three (70.9%), 29 (24.8%) and 05 (4.3%) pregnant women underwent CS under SA, GA and EA respectively. Neonates delivered by CS under GA were more likely to have a significantly low APGAR score at both the 1st (RR = 1.93, p = 0.014) and third-minute (RR = 2.52, p = 0.012) and to be resuscitated at birth (RR = 2.15, p = 0.015). Past CS, FHR pattern on CTG didn’t affect these results in multivariate analysis. Adverse maternal outcomes are shown to be higher following SA when compared to GA. Conclusion The study infers an association between CS performed for AFD under GA and foetal morbidity. This, however, failed to translate into a difference in perinatal mortality when comparing GA vs RA. This finding does not discount the role of GA, but we emphasize the need for specific precautions like adequate anticipation for neonatal resuscitation to reduce neonatal complications associated with CS performed for AFD under GA.

scholarly journals Fetal CHD and perinatal outcomes

2020 ◽  
Vol 30 (5) ◽  
pp. 686-691
Author(s):  
Christina J. Ge ◽  
Amanda C. Mahle ◽  
Irina Burd ◽  
Eric B. Jelin ◽  
Priya Sekar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Delivery ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fold Increase ◽  
Cesarean Sections ◽  
Increased Risk ◽  
Gestational Age At Delivery

AbstractObjective:To evaluate delivery management and outcomes in fetuses prenatally diagnosed with CHD.Study design:A retrospective cohort study was conducted on 6194 fetuses (born between 2013 and 2016), comparing prenatally diagnosed with CHD (170) to those with non-cardiac (234) and no anomalies (5790). Primary outcomes included the incidence of preterm delivery and mode of delivery.Results:Gestational age at delivery was significantly lower between the CHD and non-anomalous cohorts (38.6 and 39.1 weeks, respectively). Neonates with CHD had a significantly lower birth weights (p < 0.001). There was an approximately 1.5-fold increase in the rate of primary cesarean sections associated with prenatally diagnosed CHD with an odds ratio of 1.49 (95% CI 1.06–2.10).Conclusions:Our study provides additional evidence that the prenatal diagnosis of CHD is associated with a lower birth weight, preterm delivery, and with an increased risk of delivery by primary cesarean section.

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